CONCORD, N.H. (AP) — Health officials in Northern New England have not reported any cases in a growing outbreak of a rare form of meningitis that's affected at least six states.

The Centers for Disease Control and Prevention says at least 35 people have been sickened from a steroid that was distributed to 23 states. Five people have died.

All received steroid injections used mostly for back pain that have been traced back to a specialty pharmacy in Massachusetts. The pharmacy issued a recall last week and has shut down operations.

The New Hampshire Department of Health and Human Services says the recalled medication had been distributed to Pain Care LLC in Somersworth and Merrimack. The department said it was working with Pain Care to contact about 186 patients who received the medication.